Grey's Anatomy Universe Wiki
No edit summary
(44 intermediate revisions by 11 users not shown)
Line 1: Line 1:
 
{{Episode Season 5 (GA)
 
{{Episode Season 5 (GA)
|name = Elevator Love Letter
 
|season = 5
 
 
|episode = 19
 
|episode = 19
|image = [[image:Merder-engaged.jpg|250px]]
+
|image = 5x19-21.jpg
|caption = Meredith and Derek are engaged.
+
|caption = Derek proposes to Meredith.
 
|airdate = March 26, 2009
 
|airdate = March 26, 2009
 
|writer = [[Stacy McKee]]
 
|writer = [[Stacy McKee]]
|director = [[Ed Ornelas]]
+
|director = [[Edward Ornelas]]
 
|previous = [[Stand By Me]]
 
|previous = [[Stand By Me]]
|next = [[Sweet Surrender]]}}
+
|next = [[Sweet Surrender]]
  +
}}
 
{{Quote|Surgeons are all messed up. We’re butchers, messed up knife happy butchers. We cut people up, we move on. Patients die on our watch, we move on. We cause trauma, we suffer trauma. We don’t have time to worry about all the blood and death and crap it really makes us feel. Doesn’t matter how tough we are, trauma always leaves a scar. It follows us home, it changes our lives, trauma messes everybody up, but maybe that’s the point. All the pain and the fear and the crap. Maybe going through all of that is what keeps us moving forward. It’s what pushes us. Maybe we have to get a little messed up, before we can step up.|'''[[Alex Karev]]'''}}
+
{{Quote|Surgeons are all messed up. We're butchers, messed up knife happy butchers. We cut people up, we move on. Patients die on our watch, we move on. We cause trauma, we suffer trauma. We don't have time to worry about all the blood and death and crap it really makes us feel. Doesn't matter how tough we are, trauma always leaves a scar. It follows us home. It changes our lives. Trauma messes everybody up, but maybe that's the point. All the pain and the fear and the crap. Maybe going through all of that is what keeps us moving forward. It's what pushes us. Maybe we have to get a little messed up before we can step up.|'''[[Alex Karev]]'''}}
   
 
'''{{PAGENAME}}''' is the nineteenth episode of the [[Season 5 (Grey's Anatomy)|fifth season]] and the 97th overall episode of '''[[Grey's Anatomy]]'''.
 
'''{{PAGENAME}}''' is the nineteenth episode of the [[Season 5 (Grey's Anatomy)|fifth season]] and the 97th overall episode of '''[[Grey's Anatomy]]'''.
Line 18: Line 16:
 
The pressure is on for Derek as his first surgery back is part of Izzie's treatment, while Alex and George individually try to cope with their feelings for Izzie, as her boyfriend and her best friend, and her diagnosis. Izzie knits, as is alone for the day because nobody comes to visit her. Owen's PTSD hurts Cristina again, this time more violently to the concern of Callie and Meredith. Mark, Karev and Lexie try to keep a patient alive although her family are fed up of her being "almost dead" every month. Derek and Meredith get a happy ending as Cristina loses her own happy ending.
 
The pressure is on for Derek as his first surgery back is part of Izzie's treatment, while Alex and George individually try to cope with their feelings for Izzie, as her boyfriend and her best friend, and her diagnosis. Izzie knits, as is alone for the day because nobody comes to visit her. Owen's PTSD hurts Cristina again, this time more violently to the concern of Callie and Meredith. Mark, Karev and Lexie try to keep a patient alive although her family are fed up of her being "almost dead" every month. Derek and Meredith get a happy ending as Cristina loses her own happy ending.
   
== Full Summary ==
+
==Full Summary==
[[Alex Karev|Alex]] looks in on [[Izzie Stevens|Izzie]], who is fast asleep in her hospital room.
+
Alex is pacing outside Izzie's room. Izzie herself is fast asleep. A nurse asks him if he would like to have cot set up for him in her room, but he says no. He's a doctor here. He returns to pacing.
   
[[Callie Torres|Callie]] and [[Arizona Robbins|Arizona]] are at Callie's place, “dancing it out.
+
Arizona and Callie are dancing at Callie's place.
   
  +
Cristina has fallen asleep to a surgical video. Owen shuts off the light, covers her with a blanket, and stares at the fan on the ceiling. Owen's eyes close.
In [[Cristina Yang|Cristina's]] bedroom, Cristina and [[Owen Hunt|Owen]] are finally spending nights with each other, and Cristina relaxes the only way she knows how: by watching videos of surgeries. Cristina falls asleep as Owen is still watching, so Owen turns the TV off and shuts off the lights. He lays awake, staring at the ceiling fan. The scene then jumps to Owen choking Cristina violently, and it's not a dream. She struggles but cannot free herself. Callie knocks door to see if everything is okay, and following no response from either of them, she enters and is greeted by the sight of Owen choking Cristina. She intervenes to stop him and Cristina runs into the bathroom and locks the door. Callie calls [[Meredith Grey|Meredith]] and she immediately rushes over.
 
   
  +
The next moment, he's on top of Cristina, choking her. Cristina is gasping for air and tries to break free. Callie is alarmed by the noise and comes in to check. Cristina then manages to break free and flees into the bathroom. Owen comes to his senses.
Cristina assures them that she is fine and that Owen did it by accident in the middle of a nightmare. Owen, sobbing, knocks on the door asks if she is all right. Meredith will not let Cristina see him, but she ignores and walks past her. She hugs him and says that everything is fine and she is fine.
 
   
  +
Meredith's phone rings. It's Callie calling her to tell what happened.
The next morning, Meredith is back at her house. She is making breakfast when [[Derek Shepherd|Derek]] comes home. He is still unshaven and unshowered. Without saying a word, he opens the ring box and presents the diamond ring to her. She says, “No, not like this.” She reminds him that it's his first day back and it's all about Izzie. He has to save Izzie.
 
   
  +
Cristina lets Meredith into the bathroom. Meredith sees her neck and says she'll kill Owen, but Cristina says she's fine and that it was just a nightmare. Owen knocks, wanting to know if she's all right. Cristina opens the door. Owen says he's sorry. He doesn't know what happened. Cristina tells him to look at her and assures him she's okay. She holds him as he cries and keeps repeating it's okay.
At work, Cristina is wearing a turtle-neck to cover up the strangle marks. Meredtih does not want Cristina to cover for her boyfriend because neither of them is okay.
 
   
  +
Meredith's having breakfast as Derek enters the kitchen. He sits down with her and gives her the ring. She says not like this. Today is about Izzie and his gift to save her. He can do it. Derek decides to go take a shower.
[[George O'Malley|George]] is upset that Izzie didn't tell him about her illness. He refuses to think about it, and asks Callie if he can be on her service today in order to avoid thinking about Izzie, and takes the charts and walks away, barely hearing the surgeries for the day.
 
   
  +
Cristina is wearing a turtleneck under her scrubs to hide her bruised neck. Meredith says this is not okay, and neither is Owen. Alex asks Meredith if Derek is okay to be back. Today is not just any patient, it's Izzie. Meredith says he's fine.
[[Miranda Bailey|Bailey]] greets the residents before they go into Izzie's room. She tells them all that today Izzie needs them to be friends, not doctors.
 
   
  +
Callie sees Derek, Richard, Alex, Cristina, and Meredith walk by. George comes over and she's surprised he's not going to the big presentation with Izzie. George says he was the very last to know about Izzie. He wants to work and asks Callie if she has room on her service. She does. George takes a chart from her and walks off.
During the presentation, Derek comments that he is surprised the cancer was not caught sooner, as the location of the metastases can produce intense hallucinations, and the penny drops for Alex. The oncologist, [[Rebecca Swender]], is overseeing all of Izzie's treatment and she tells them that every surgeon on Izzie's case reports to Swender first. After the "doctors" leave, Izzie knits and reminds her friends that they have other patients and tells them to go save lives.
 
   
  +
As doctors enter Izzie's room, Bailey tells Meredith, Alex, and Cristina that if they enter Izzie's room, they are her friends, not her doctors. She needs people to hold her hand as she's got enough doctors. They enter the room where Izzie stops knitting. Bailey tells Izzie they have a lot of surgeries and procedures lined up for the coming weeks. One of those surgeries will be removing mets from her liver. Also, Dr. Parker from OB will harvest healthy eggs before she undergoes any radiation so she has the option of having babies for later. Derek says their primary concern for today is the mets on her temporal lobe. Derek is surprised they didn't catch it sooner as it can cause intense hallucinations. Dr. Swender asks if they're done. She tells Izzie that there will be lots of surgeries even for the mets they already know about. Swender will administer chemo, radiation, and immunotherapy. The treatment will be aggressive and harsh, so Izzie should prepare herself. Swender will be overseeing every procedure Izzie has. She welcomes everyone to the cancer wing. The doctors leave. Izzie tells her friends to go save lives now. They leave for rounds, leaving her alone in her room, knitting.
Derek asks Alex, as Izzie's boyfriend, if he has any questions before her surgery today. Alex doesn't say much, but makes a jibe at Derek, commenting "Just try and keep her frontal lobe inside her skull this time." Derek doesn't respond. Later, [[Richard Webber|Richard]] awkwardly asks Alex whether he wants to produce a sperm sample because they are harvesting Izzie's eggs prior to her treatment, and the eggs have a better chance of surviving if they are fertilized. Without so much as a thought, Alex immediately agrees.
 
   
  +
Outside Izzie's room, Derek tells Alex it seems like the tumor hasn't grown since her last scans. Derek asks if he has any concerns. Alex wants him to keep Izzie's frontal lobe in her skull. Derek enters Izzie's room to talk about the surgery. Bailey asks Alex if he's coming, but he says he has to go as he's on an old lady.
[[Mark Sloan|Mark's]] patient is an elderly woman unlikely to make it through the day. But her nephews and niece are anxious to catch flights and are not bothered to stick around until she dies.
 
   
  +
Jackie introduces Mark to her brothers Luke and Tobin, who flew in this morning. Their aunt Joyce is very sick. Mark says it's time to say goodbye. Tobin wants to know what time frame they're talking about. She probably won't make it another day. Tobin has a flight to catch in the morning and he can't change it when it's past noon. Luke has to catch a plane tonight. Mark, Lexie, and Alex seem to find them a bit insensitive.
Dr. Swender wants to tell Izzie that her cancer treatment, specifically her chemotherapy, is going to be as harsh as chemotherapy can get, but Cristina is reluctant to do so, pointing out studies that claims that patient have higher surgical complications on the table if they receive bad news before undergoing surgery.
 
   
  +
Cristina is walking with Swender, who's doubting about Derek. Swender reviews Izzie's labs and decides to go for IL-2. It's about as bad as it gets. Cristina doesn't want her to tell Izzie now as studies have shown telling patients bad news before surgery drastically increases their chance of complications. Swender says the news remains the same, whenever delivered, and she has time now. Cristina says she believes Izzie is down in radiology, so Swender has to wait an hour.
Meredith and Callie run interference when Owen approaches Cristina, preventing him from getting anywhere near her. Owen looks at Meredith with sorrow, but Meredith is stern and not letting him pass.
 
   
  +
Richard paged Alex to talk about Izzie's eggs. Frozen eggs have a better survival rate when they're fertilized. It's a lot to digest so Alex can think about it. Alex asks for the cup.
Owen and Derek go to the roof of the hospital to receive a motorcyclist with no helmet, sustaining massive head trauma, who was being helicoptered in. The sound of the helicopter makes Owen freeze up for a moment, Derek remarking the patient is DOA, and upon seeing that Hunt still is frozen still, Derek snaps him out of it.
 
   
  +
Callie asks Meredith if Cristina is okay. Meredith says she says she is, but she doesn't believe her. Owen comes over, but Meredith blocks him from going over to Cristina.
Cristina wants to complain about Dr. Swender to Meredith, but Mer wants to discuss Owen instead. Cristina says that Owen is wounded, and this is no different than if he came home from Iraq without an arm or a leg.
 
   
  +
Owen and Derek are on the helipad, where a helicopter brings in a patient with a massive head trauma following a motorcycle accident. Owen tells Derek it's good to have him back. Owen appears to be hypnotized by the rotor blades. It takes some time before Derek can get through to him. The patient's DOA.
Outside the hospital, Derek reminds Owen that PTSD is a real injury with studies showing altered brain anatomy in patients, but it can also be treated and managed. Owen gets defensive, reminding Derek that he tried to cut out most of a woman's brain and then walked away.
 
   
  +
Alex is staring at the cup in an on-call room. He gets paged.
Richard knocks on the door of the room in which Alex is supposed to be "giving his contribution". Alex yells at him to go away, so Meredith takes that opportunity to come in and talk. Alex claims through grief and rage that he should have seen the signs: seeing Denny, what kind of doctor does this make him now, and what about Izzie's future?
 
   
  +
Cristina is complaining about Swender having no vision. Meredith tells her Owen obviously has issues, but that doesn't mean Cristina has to stand by him. Cristina says it's like if he lost a leg or had a heart attack. She can't walk away just because he has war wounds. It's not as bad as Meredith thinks it is.
Cristina finds Owen in the basement with the secret steam vent. He tells her to stay away from him because he almost killed her. She says gently that she knows her limits and knows how much she can handle.
 
   
  +
Alex and Lexie are shocking Joyce, successfully reviving her. Jackie and her brothers are disappointed. Alex calls them vultures. Tobin explains Joyce had one month to live, three years ago. They were crushed and they stayed with her for weeks and said their goodbyes, and then she stabilized. Ever since, Joyce has been in and out of the hospital every month. They always jump on planes and say their goodbyes again. Each time, Joyce winds up getting better. Everyone is ready for her to move on.
Bailey comes to check on Izzie. While performing her observations, she quizzes Izzie on her medical knowledge, basing it from one of her surgeries today, so that she won't get rusty. She wants Izzie to be able to do this stuff because Izzie will have to be able to teach how to do it a year from now. Izzie asks her if she really thinks she'll be here a year from now, and Bailey says matter-of-factly, “Yes, I do.”
 
   
  +
Derek and Owen are sitting in the ambulance bay. Derek tells him researchers are close to understanding the physical side of the psychological trauma that is PTSD. Owen asks what Meredith told him about last night. Derek says PTSD can be healed. Owen says he came back in one piece. Lots of guys came back with real injuries. Derek says he can help, but Owen says he's not the one who needs help here. He's not the one who took out half a woman's brain. He suggests Derek look in the mirror. Owen goes back inside.
Stressed out, Derek spends a considerable amount of time in the practice lab going over the surgery he has to perform on Izzie.
 
   
  +
Richard is outside the on-call room to check how Alex is doing. Alex would be better if he weren't out there listening. Richard apologizes. Meredith comes in and says she came in case Alex needed to talk. Alex says talking won't help. A cup with his swimmers won't make everything okay. Alex wonders if they'll even get a chance to use the frozen embryos. He wonders if Izzie will survive. Izzie told him she was seeing a ghost, but he's so used to crazy women in his life that he didn't think about it. This isn't how it's supposed to happen, how he wanted to do this. 
Alex deposits his cup on the table right next to where Richard is eating lunch. Richard gets uncomfortable, and reminds him that he needs to actually talk to Izzie about procreating at some point.
 
   
  +
Cristina enters the vent room, but Owen's already in there. She says she hasn't seen him all day. He wonders what if he hadn't woken up. He has no memory of what happened. He would never hurt her, but he did. He doesn't understand how his hands could have been capable. Cristina tells him not to blame himself for something that's out of his control. Owen says they have to stop seeing each other. Cristina knows her limits. She'll decide what she can handle. She sees the scratches on his neck and leaves the room.
The residents eat lunch in the cafeteria, but they all eventually realize that none of them have checked in on Izzie today. Bailey goes in to check on Izzie again and is surprised to see that Izzie has finished the scarf she was knitting. She has had a lot of time to since no friends came to visit.
 
   
  +
Izzie uses Bailey to measure the scarf she's knitting. Bailey thinks it's for Alex and says she hasn't seem him much today. Izzie says he's working like everybody else. She told them to do that. Bailey says she has a colectomy this afternoon. She asks what Izzie would do to divide the cecum. Bailey has decided not to let Izzie fall behind as she'll need to know how to do this a year from now. She really believes Izzie will be around then.
Callie confesses to Arizona that she wanted Izzie to die while she was with George. Callie feels guilty that she wished death upon someone, but Arizona reminds her that she isn't praying for Izzie's death anymore.
 
   
  +
Derek's in the OR by himself, talking himself through the procedure. He's breathing heavily and staring at his hands, then decides to start over.
Alex's old patient starts coding again, and her relatives roll their eyes, wondering if this is the time she is actually going to die. Alex throws them out, charges the paddles and revives her again. The patient regains consciousness and hears Alex tell Lexie not to let her heartless nephews and niece in the room again. But the old lady says no, they are impatient, but they are always by her side, every month. They are her people, and having people is better than having no people.
 
   
  +
Richard's eating lunch in a conference room as Alex delivers the filled cup. Richard tells him to go talk to Izzie as they're basically conceiving a child today. Alex says he has done his part and leaves. Richard moves the cup away from his food.
Alex runs to Izzie's room, but she has already been taken to the OR. Before Derek goes to operate on Izzie, Meredith enters the scrub room with Derek's scrub cap with [[Ferry Boats|ferry boats]]. He runs out to tell Meredith that he's not ready to operate because he needs her to say yes. Whatever happens in that operating room today, he needs to know he still has Meredith afterwards. Meredith says no, but that she loves him and he better go back in there and operate because she knows he can do it.
 
   
  +
The residents sit down in the cafeteria. Nobody knows how Izzie is doing, not even Alex.
On the table, Izzie tells Bailey that the scarf she was making was for her. Derek remarks it's a beautiful night to save lives, and then begin.
 
   
  +
Izzie's in her room by herself as Bailey comes in. She notices Izzie has finished the scarf. She asks if no one came up to visit. Izzie understands and she says Bailey doesn't need to keep checking on her. Bailey says she has to be there to start Izzie on her meds before the surgery. She talks about her colectomy. She found a mass inside the patient and talks about how they resected it.
George meanwhile is taking his anger out using a hammer and smashing plaster casts. He tells Callie he doesn't want to talk about it because he is mad that Izzie kept her condition from him and lied about it, and when she needed help she turned to Cristina, of all people. Callie points out that it could also be because she is his best friend, and she might die on him, the more poignant of all reasons. For his own good, Callie takes the hammer and takes George to wait for Izzie, but as George refuses, she reminds him that he slept with her and because of that, she wished Izzie was dead for months. This, he owes her, but she does know George, she loved him once, and she knows that George cares if Izzie lives or dies.
 
   
  +
In the chapel, Callie tells Arizona she wished Izzie dead for weeks. And now, it's happening. She wonders what kind of person would wish for this to happen. Arizona asks if she's praying for Izzie to die right now. Callie says no. She's praying for Izzie to live.
Alex, Meredith and Cristina camp outside the OR, waiting for news of Izzie. They are joined by some interns, but as Meredith tells them to leave, Alex tells them they can stay - some people are better than no people.
 
   
  +
Joyce is coding again. Alex asks her nephews and niece to wait outside. He shocks Joyce and asks her not to give her family the satisfaction. He shocks her again, which revives her. Joyce opens her eyes and Alex introduces himself. He tells her she worked hard today. Joyce says her family is impatient. It's been a long time, but they always come. They are her people. People keep you going. People are better than no people.
Swender crashes Izzie's surgery, second-guessing Derek's every move, leading Bailey to defend his actions.
 
   
  +
Derek is scrubbing in with Richard by his side. Meredith comes in to give Derek his ferry boat scrub cap.
Lexie is all by herself with her patient crashes again and is unable to resuscitate her. She tells the impatient relatives that their aunt has died and she has done everything she can, until the monitor shows she has a pulse again. Lexie listens to her heart and tells them that it is the pacemaker, and she is actually gone. Since she is only an intern, she cannot call time of death and goes to find her superior.
 
   
  +
Derek follows Meredith out to the hallway. He needs her to say yes now, so it's regardless of the outcome of the surgery. She says she can't, not if agreeing to marry him will make it okay for Izzie to die. She loves him and he can do this. She knows he can.
Alex, Meredith and Cristina are camped outside the OR, joined by Callie and George and more interns. Meredith and Cristina fight over what has happened with Owen.
 
   
  +
Alex rushes into Izzie's room, but she's gone.
Dr. Sloan confirms Lexie's decision and deactivates the pacemaker. Now the patient is dead, they family decide to stay a bit longer to pay their respects.
 
   
  +
Izzie's on the table in Derek's OR. Izzie looks at him as he enters. He tells her he'll see her soon. She hopes so. Bailey knows so. Izzie tells Bailey the scarf is for her, in case anything goes wrong. Derek says it's a beautiful night to save lives. Bailey then puts Izzie under.
The Chief walks into the hallway to find a small army of his own staff, wondering what they are doing. Alex tells him they are waiting for Izzie, and Richard replies that they are all scared. And so is he.
 
   
  +
George is smashing a cast with a hammer. Callie doesn't get why he's not with Izzie, but he doesn't want to talk about it. He asked Izzie hundreds of time what was wrong and she ignored him, and when she actually needed help, she turned to Cristina, of all people. Callie says there's also the fact that his best friend might die on him. Callie takes the hammer from his hands. She says they're going to wait for Izzie, and he owes her this, because she wished Izzie dead because he slept with her. Callie knows him and she knows that he cares if Izzie lives or dies.
In surgery, Derek is still doubting himself and Swender keeps questioning his actions. He finally gets his confidence back and tells Swender that he knows what he's doing.
 
   
  +
Meredith informs Alex and Cristina that the surgery has started. Intern Steve comes over and asks if the surgery has started. Meredith wants the interns to go, but Alex says they can stay as people are better than no people.
Bailey comes out to tell them good news and bad news. The good news is that Derek was able to take out all of the tumor from her brain and she will be in the PACU, but she is fine. The bad news is that they were all terrible friends to Izzie today.
 
   
  +
In the OR, Derek is ready to buzz the superficial temporal artery. He's going for tenting sutures. Bailey says he can take his time. Everyone here is on his side. Swender asks if they're gonna hold with all the friable scar tissue. Bailey trusts him as she saw him do it with even more friable tissue.
After surgery, Derek whines to Richard that Meredith turned down his proposal twice. Richard tells Derek that it was Meredith's idea to have Izzie's eggs harvested because she was confident Derek would save her, and he finally shaves.
 
   
  +
Lexie is shocking Joyce, but it's unsuccessful this time. Joyce is gone. Jackie thanks her. Suddenly, Joyce heart starts beating again. The family rolls their eyes and says it's never going to end. Lexie listens with her stethoscope and says it's just Joyce's pacemaker. She's really gone. However, Lexie has to get her superior as she's not authorized to call time of death in this situation.
Alex looks on at Izzie in the PACU and tells her he is here. Bailey walks by, wearing the scarf, and walks on as he sees Alex there.
 
   
  +
Callie and George joins the others who are waiting for Izzie. Meredith once again says the choking is unacceptable, but Cristina bounces back that she's had a ring thrown in her face.
Cristina approaches Owen in an on-call room to tell him that Izzie's surgery went well. Owen asks to hold Cristina. They consummate their relationship just when they realize that they can't be together.
 
   
  +
Mark shuts the pacemaker down and calls time of death. Lexie tells Jackie, Tobin, and Luke they can now leave and catch their plane. They actually want to stay a little while longer. They all start crying.
Meredith tries to walk into an empty elevator, but Richard stands in front of the door, blocking her way for some reason. Meredith presses the button again, and the other one opens.
 
   
  +
Richard asks the waiting doctors what they're doing. Alex says they're waiting for Izzie. Richard says he's scared, too.
Derek is in the elevator. He has plastered the walls of the elevator with MRI scans of all of the successful surgeries they have had together. He tells her that she doesn't freeze. She's seen the worst and been through the worst, but that is how she has the strength to help everyone. Her dark and twistiness is a virtue, not a flaw. He doesn't get down on one knee. He doesn't ask the question. He simply says that he loves her and wants to spend the rest of his life with her, and she says the same.
 
   
  +
Derek finds some of the Sylvian vessels are wrapped around the tumor capsule. He asks for a Penfield four, which surprised Swender. Derek is sure of his choice and finds his confidence.
Cristina lies Owen's arms, Cristina whispers she is afraid to fall asleep. She cannot have a relationship with someone she is afraid of in this way.
 
   
  +
Bailey goes to tell the doctors that Derek managed to resect all of the tumor. Izzie's going to be in the PACU for an hour, but she'll be fine. Everyone is relieved. Bailey tells Izzie's friends that that is not thanks to them. She tells them to do better tomorrow.
Hunt is in a [[Computed Tomography|CT scanner]], apologizing to Derek as he finally gets help.
 
   
  +
Richard wonders why Derek and Meredith aren't celebrating. Derek says Meredith turned him down twice. Richard says Derek showed her his dark side, but Meredith never struck him as someone who's afraid of the dark. Derek doesn't know. Richard says it was Meredith's idea to ask Izzie about harvesting her eggs. That shows that she was confident that Derek would succeed. Meredith believes in him. Derek then starts shaving off his beard.
Cristina stares up at the ceiling fan, in her apartment in tears. Meredith walks in and reveals she is engaged. There is no real celebration of their engagement. Meredith goes over to Cristina where she learns that she broke up with Owen. She climbs into bed with Cristina and they both lay there quietly with each other.
 
   
  +
Alex enters Izzie's room. He's crying and tells her he's right here. He takes her hand. Bailey, wearing her scarf, passes by outside the room.
Alex climbs into Izzie's hospital bed and holds her hand.
 
   
  +
Cristina tells Owen that Izzie's surgery went well. He wishes things were different. So does she. He asks if he can hold her. She lets him and they kiss. They take off their shirts and lie down on a bed, and proceed to have sex.
== Cast ==
 
  +
  +
Meredith is about to get on an elevator, but Richard rushes over and tells her she can't take that one. He blocks her until the doors close. She pushes the button again. The other elevator arrives. Its walls are full of scans and files. Derek welcomes her as she gets in. He shows her Katie Bryce's CT. That was their first surgery together. Another scan shows a patient whose cerebral cyst they removed. It was tough, but they did it. After that surgery, he kissed her in the stairwell. Another scan is from the time Bailey kicked Meredith out of the OR because she caught them in his car. Another scan is from the time she held a clamp for 7 hours and never flinched. That's when he knew she was going to be a great surgeon. Also there are Beth Monroe's scans, the first patient to survive their trial. Meredith talked him into operating on her. That's when he knew he needed her. He finally shows her Izzie's post-op head CT from today. Her brain is tumor-free. Derek says that's because of Meredith, as she got him into the OR. If there's a crisis, Meredith moves forward instead of freezing, and she gets everyone else to move forward, because she's seen and survived worse. She knows they'll survive, too. Being dark and twisty is a strength, not a flaw. It makes her who she is. He won't get down on one knee to ask her a question. He loves her and he wants to spend the rest of his life with her. She says she wants to spend the rest of hers with him. They kiss.
  +
  +
Owen and Cristina are lying in bed. She doesn't think she can handle this after all. She's sorry, but lying her in his arm, she's afraid to fall asleep.
  +
  +
Owen's in the MRI. He apologizes to Derek for what he said earlier. Derek says it's all forgotten. Owen thanks him for doing this. Derek activates the scanner.
  +
  +
At home, Cristina is staring at the fan. Meredith enters her bedroom and tells Cristina she's engaged. Cristina says she broke up with Owen. Meredith lies down next to her.
  +
  +
Alex lies down in bed with Izzie. She wakes up and he tells her he snooched into a cup for her today. She guesses she should thank him. Meanwhile, Alex's voice over says that maybe going through all the pain that comes with trauma is what keeps you moving forward. Maybe we have to get a little messed up before we can step up.
  +
  +
==Cast==
 
<gallery type="slideshow" hideaddbutton="true" crop="true">
 
<gallery type="slideshow" hideaddbutton="true" crop="true">
 
519MeredithGrey.png|Meredith Grey
 
519MeredithGrey.png|Meredith Grey
Line 127: Line 137:
 
519InternsPierceRyanandMegan.png|Ryan Spalding (center)
 
519InternsPierceRyanandMegan.png|Ryan Spalding (center)
 
519Luke.png|Luke
 
519Luke.png|Luke
519InternSteve.png|Intern Steve (right)
+
519InternSteve.png|Intern Steve Mostow (right)
 
519InternsPierceRyanandMegan.png|Intern Pierce Halley (left)
 
519InternsPierceRyanandMegan.png|Intern Pierce Halley (left)
 
519InternLaura.png|Intern Laura
 
519InternLaura.png|Intern Laura
 
519InternLeo.png|Intern Leo Byrider (left)
 
519InternLeo.png|Intern Leo Byrider (left)
 
519Nurse.png|Nurse (rear)
 
519Nurse.png|Nurse (rear)
519InternGraciella.png|Intern Graciella (left)
+
519InternGraciella.png|Intern Graciella Guzman (left)
 
519InternClaire.png|Intern Claire (left)
 
519InternClaire.png|Intern Claire (left)
519InternsPierceRyanandMegan.png|Intern Megan (right)
+
519InternsPierceRyanandMegan.png|Intern Megan Nowland (right)
 
</gallery>
 
</gallery>
 
===Main Cast===
 
===Main Cast===
Line 150: Line 160:
 
*[[Patrick Dempsey]] as [[Derek Shepherd|Dr. Derek Shepherd]]
 
*[[Patrick Dempsey]] as [[Derek Shepherd|Dr. Derek Shepherd]]
   
=== Guest Stars ===
+
===Guest Stars===
 
*[[Kimberly Elise]] as [[Rebecca Swender|Dr. Rebecca Swender]]
 
*[[Kimberly Elise]] as [[Rebecca Swender|Dr. Rebecca Swender]]
 
*[[Jessica Capshaw]] as [[Arizona Robbins|Dr. Arizona Robbins]]
 
*[[Jessica Capshaw]] as [[Arizona Robbins|Dr. Arizona Robbins]]
*[[Molly Hagan]] as Jackie
+
*[[Molly Hagan]] as [[Jackie (Elevator Love Letter)|Jackie]]
*[[Todd Waring]] as Tobin
+
*[[Todd Waring]] as [[Tobin]]
 
*[[Brandon Scott]] as [[Ryan Spalding|Dr. Ryan Spalding]]
 
*[[Brandon Scott]] as [[Ryan Spalding|Dr. Ryan Spalding]]
   
=== Co-Starring ===
+
===Co-Starring===
*[[Tim Maculan]] as Luke
+
*[[Tim Maculan]] as [[Luke]]
 
*[[Mark Saul]] as [[Steve Mostow|Intern Steve]]
 
*[[Mark Saul]] as [[Steve Mostow|Intern Steve]]
 
*[[Joseph Williamson]] as [[Pierce Halley|Intern Pierce]]
 
*[[Joseph Williamson]] as [[Pierce Halley|Intern Pierce]]
Line 167: Line 177:
 
*[[Amrapali Ambegaokar]] as [[Dani Mandvi|Intern Dani]]
 
*[[Amrapali Ambegaokar]] as [[Dani Mandvi|Intern Dani]]
 
*[[Tymberlee Chanel]] as [[Claire (Intern)|Intern Claire]]
 
*[[Tymberlee Chanel]] as [[Claire (Intern)|Intern Claire]]
*[[Molly Kidder]] as [[Megan Mostow|Intern Megan]]
+
*[[Molly Kidder]] as [[Megan Nowland|Intern Megan]]
 
*[[Janeline Hayes]] as [[Season 5 (Grey's Anatomy)/Unnamed Characters#Elevator Love Letter|Medic]]
 
*[[Janeline Hayes]] as [[Season 5 (Grey's Anatomy)/Unnamed Characters#Elevator Love Letter|Medic]]
   
 
===Uncredited===
 
===Uncredited===
*Frances Bay as Aunt Joyce
+
*Frances Bay as Joyce Wallington
   
 
==Medical Notes==
 
==Medical Notes==
  +
===[[Izzie Stevens]]===
  +
*'''Diagnosis:'''
  +
**Stage IV metastatic melanoma
  +
**Liver mets
  +
**Skin mets
  +
**Brain met
   
  +
*'''Doctors:'''
== Music ==
 
  +
**[[Derek Shepherd]] ''(neurosurgeon)''
  +
**[[Rebecca Swender]] ''(surgical oncologist)''
  +
**[[Miranda Bailey]] ''(surgical resident)''
  +
**[[Cristina Yang]] ''(surgical resident)''
  +
  +
*'''Treatment:'''
  +
**Liver met resections
  +
**Brain met resection
  +
**DTIC
  +
**High-dose IL-2
  +
  +
Izzie had been admitted to the hospital to start her cancer treatment. They planned to resect her liver mets and harvest eggs from her ovaries. Derek also wanted to address her brain mets. He eventually took her into surgery to remove them. The surgery went well and was successful.
  +
  +
===Callie's Patients===
  +
*'''Diagnosis:'''
  +
  +
*'''Doctors:'''
  +
**[[Callie Torres]] ''(orthopedic surgery resident)''
  +
**[[George O'Malley]] ''(surgical resident)''
  +
  +
*'''Treatment:'''
  +
**Hip replacement
  +
**Tibia/fibula repair
  +
  +
Callie told George she had three hip replacements scheduled that day, plus a tib/fib repair.
  +
  +
===Joyce Wallington===
  +
*'''Diagnosis:'''
  +
  +
*'''Doctors:'''
  +
**[[Mark Sloan]] ''(plastic surgeon)''
  +
**[[Alex Karev]] ''(surgical resident)''
  +
**[[Lexie Grey]] ''(surgical intern)''
  +
  +
*'''Treatment:'''
  +
  +
Joyce's family was told she had less than 24 hours to live. She'd had surgery and was not doing well. She coded several times and was brought back before finally dying.
  +
  +
===ER Patient===
  +
*'''Diagnosis:'''
  +
  +
*'''Doctors:'''
  +
**[[Derek Shepherd]] ''(neurosurgeon)''
  +
**[[Owen Hunt]] ''(trauma surgeon)''
  +
  +
*'''Treatment:'''
  +
  +
Owen and Derek waited on the roof together for a patient with head trauma. The patient was DOA.
  +
  +
===Bailey's Patient===
  +
*'''Diagnosis:'''
  +
**Tumor
  +
  +
*'''Doctors:'''
  +
**[[Miranda Bailey]] ''(surgical resident)''
  +
  +
*'''Treatment:'''
  +
**Colectomy
  +
**Tumor resection
  +
  +
Bailey told Izzie she was doing a colectomy that afternoon and asked her questions about it. She later came back to tell Izzie that the surgery went well. She said that she found a tumor during the surgery which she resected.
  +
  +
===[[Owen Hunt]]===
  +
*'''Diagnosis:'''
  +
**PTSD
  +
  +
*'''Doctors:'''
  +
**[[Derek Shepherd]] ''(neurosurgeon)''
  +
  +
*'''Treatment:'''
  +
  +
Owen had Derek do an MRI after Cristina told him she was afraid to fall asleep with him there because Derek had mentioned that you could see the changes in brains with PTSD.
  +
  +
==Music==
 
{| class="wikitable"
 
{| class="wikitable"
 
! scope="col" style="width:157px;" |Song
 
! scope="col" style="width:157px;" |Song
Line 184: Line 274:
 
| align="center" |Gomez
 
| align="center" |Gomez
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Alex paces outside Izzie's room.
*Callie and Arizona dance it out together
 
  +
*Callie and Arizona dance it out together.
  +
*Owen and Cristina go to sleep after watching a surgical video. Owen stares at the ceiling fan.
 
|-
 
|-
 
| align="center" |"The Weight of Us"
 
| align="center" |"The Weight of Us"
 
| align="center" |Sanders Bohlke
 
| align="center" |Sanders Bohlke
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Alex tells Meredith this is not how he and Izzie were supposed to make a baby.
*
 
  +
*Cristina and Owen talk in the vent room. She assures him she knows her own limits.
  +
*Bailey checks up on Izzie, who's knitting a scarf.
 
|-
 
|-
 
| align="center" |"That Home"
 
| align="center" |"That Home"
 
| align="center" |The Cinematic Orchestra
 
| align="center" |The Cinematic Orchestra
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Alex goes to Izzie's room and she is not there.
*
 
  +
*Izzie is in the O.R. with Derek and Miranda. She tells the scarf is for Miranda. Derek says it is a beautiful night to save lives.
 
|-
 
|-
 
| align="center" |"Rise Up"
 
| align="center" |"Rise Up"
 
| align="center" |Ben Lee
 
| align="center" |Ben Lee
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Aunt Joyce finally dies and her family decides to stay a little while longer to say goodbye for real.
*Family watches thier aunt die. Everyone waits outside the O.R
 
  +
*The residents and interns are waiting for Izzie, and Richard admits he's scared, too.
  +
*In the OR, Derek finds his confidence back.
  +
*Bailey tells the waiting doctors that Izzie is fine. She tells Izzie's friends to do better tomorrow.
 
|-
 
|-
 
| align="center" |"With the Notes in My Ears"
 
| align="center" |"With the Notes in My Ears"
 
| align="center" |Peter Broderick
 
| align="center" |Peter Broderick
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Derek shaves off his beard.
*
 
  +
*Alex tells Izzie he's here for her. Bailey, wearing her scarf, watches from outside the room.
  +
*Cristina and Owen have sex in an on-call room.
 
|-
 
|-
 
| align="center" |"We Do What We Want To"
 
| align="center" |"We Do What We Want To"
 
| align="center" |O+S
 
| align="center" |O+S
 
| style="text-align:left;" |
 
| style="text-align:left;" |
  +
*Derek shows Meredith the scans in the elevator and proposes to her in the elevator.
*
 
  +
*She accepts his proposal.
|-
 
  +
*Cristina admits she can't handle this thing with Owen after all as she's scared to lie in his arms.
| align="center" |"Like a Ghost"
 
  +
*Owen finally accepts Derek's help and gets in the scanner.
| align="center" |Thom Barg
 
  +
*Meredith tells Cristina she's engaged, and Cristina tells her she broke up with Owen.
| style="text-align:left;" |
 
  +
*Alex lies down with Izzie and tells her about the cup. 
*
 
 
|}
 
|}
  +
<gallery orientation="landscape" position="center" hideaddbutton="true" bordersize="none" spacing="medium">
  +
"Little Pieces" - Gomez
  +
"The Weight of Us" - Sanders Bohlke
  +
"That Home" - The Cinematic Orchestra
  +
"Rise Up" - Ben Lee
  +
"With the Notes In My Ears" - Peter Broderick
  +
"We Do What We Want To" - O+S
  +
</gallery>
   
== Notes and Trivia ==
+
==Notes and Trivia==
 
[[File:Grey's Anatomy 5x19 Promo|thumb|300px|right]]
 
[[File:Grey's Anatomy 5x19 Promo|thumb|300px|right]]
*This episode's title originated from the song ''Elevator Love Letter'', originally sung by the Canadian band, '''Stars'''.
+
*This episode's title originated from the song ''Elevator Love Letter'', originally sung by the Canadian band, ''Stars''.
*This episode scored 16.10 million episodes.
+
*This episode scored 16.10 million viewers.
 
*When Meredith is leaning on the OR Board while Izzie's in surgery you can see Izzie's birthday as 06/23/81. So, that would make Izzie almost 28 years old
 
*When Meredith is leaning on the OR Board while Izzie's in surgery you can see Izzie's birthday as 06/23/81. So, that would make Izzie almost 28 years old
 
*While the Chief is eating, Alex hands him a cup of his sperm. After Alex leaves, a disgusted Chief moves the cup away from him with his fork. This is illogical as he uses the same fork to eat.
 
*While the Chief is eating, Alex hands him a cup of his sperm. After Alex leaves, a disgusted Chief moves the cup away from him with his fork. This is illogical as he uses the same fork to eat.
 
*There's a deleted scene of this episode in which Alex, Meredith, George, Cristina, Callie and Lexie are waiting in Izzie's room for her to wake up. While they are waiting, Bailey walks by, wearing the scarf that Izzie made her.
 
*There's a deleted scene of this episode in which Alex, Meredith, George, Cristina, Callie and Lexie are waiting in Izzie's room for her to wake up. While they are waiting, Bailey walks by, wearing the scarf that Izzie made her.
   
==Gallery ==
+
==Gallery==
 
===Episode Stills===
 
===Episode Stills===
<gallery orientation="portrait" position="center" spacing="small" bordersize="none">
+
<gallery orientation="landscape" position="center" spacing="small" bordersize="none" hideaddbutton="true">
5x19-28.jpg
+
5x19-1.jpg
5x19-27.jpg
+
5x19-2.jpg
5x19-26.jpg
+
5x19-3.jpg
5x19-25.jpg
+
5x19-4.jpg
5x19-24.jpg
+
5x19-5.jpg
5x19-23.jpg
+
5x19-6.jpg
5x19-22.jpg
+
5x19-7.jpg
5x19-21.jpg
+
5x19-8.jpg
5x19-20.jpg
+
5x19-9.jpg
5x19-19.jpg
 
5x19-18.jpg
 
5x19-17.jpg
 
5x19-16.jpg
 
5x19-15.jpg
 
5x19-14.jpg
 
5x19-13.jpg
 
5x19-12.jpg
 
 
5x19-11.jpg
 
5x19-11.jpg
5x19-10.jpg
+
5x19-12.jpg
5x19-9.png
+
5x19-16.jpg
5x19-8.png
+
5x19-17.jpg
5x19-7.png
+
5x19-18.jpg
5x19-6.png
+
5x19-19.jpg
5x19-5.png
+
5x19-21.jpg
5x19-4.png
+
5x19-24.jpg
5x19-3.png
+
5x19-27.jpg
5x19-2.png
+
5x19-28.jpg
5x19-1.png
 
 
5x19-29.jpg
 
5x19-29.jpg
 
5x19-30.jpg
 
5x19-30.jpg
Line 265: Line 364:
 
5x19-36.jpg
 
5x19-36.jpg
 
5x19-37.jpg
 
5x19-37.jpg
  +
5x19-38.jpg
 
</gallery>
 
</gallery>
   
==Quotes ==
+
==Quotes==
:'''[[Richard Webber|Richard]]:''' ''(knocking)'' Karev? Just checking in. Seeing how you're coming–ah, just seeing how you're doing.
+
:'''[[Richard Webber|Richard]]:''' ''(knocking)'' Karev? Just checking in. Seeing how you're coming– ah, just seeing how you're doing.
 
:'''[[Alex Karev|Alex]]:''' I'd be doing a lot better if you weren't on the other side of the door listening.
 
:'''[[Alex Karev|Alex]]:''' I'd be doing a lot better if you weren't on the other side of the door listening.
 
:'''[[Richard Webber|Richard]]:''' Right, right. Sorry.
 
:'''[[Richard Webber|Richard]]:''' Right, right. Sorry.
Line 275: Line 375:
 
:'''[[Meredith Grey|Meredith]]:''' ''(entering anyways)'' You left the door unlocked. That's bold.
 
:'''[[Meredith Grey|Meredith]]:''' ''(entering anyways)'' You left the door unlocked. That's bold.
 
----
 
----
:'''[[Alex Karev|Alex]]:''' You think talking will help? You think a dixie cup of my swimmers will make everything okay? It's crap. This is crap! You just cant go messing with peoples heads like that! Even if she freezes the embryos you think, you think we'll get a chance to use them?! You think she'll still be here? You think she'll survive all this?! You think...I think..she told me, she told me she was seeing a ghost, okay? and I'm so used to all the crazy chicks in my life that I didn't even...I'm a doctor. A doctor! and I didn't even think to..and now she's..this is wrong. This isn't how it's supposed to happen.
+
:'''[[Alex Karev|Alex]]:''' You think talking will help? You think a dixie cup of my swimmers will make everything okay? It's crap. This is crap! You just cant go messing with peoples heads like that! Even if she freezes the embryos you think, you think we'll get a chance to use them?! You think she'll still be here? You think she'll survive all this?! You think... I think.. She told me, she told me she was seeing a ghost, okay? And I'm so used to all the crazy chicks in my life that I didn't even... I'm a doctor. A doctor! And I didn't even think to... And now she's... This is wrong. This isn't how it's supposed to happen.
 
:'''[[Meredith Grey|Meredith]]:''' I know.
 
:'''[[Meredith Grey|Meredith]]:''' I know.
 
:'''[[Alex Karev|Alex]]:''' It's crap.
 
:'''[[Alex Karev|Alex]]:''' It's crap.
Line 281: Line 381:
 
:'''[[Alex Karev|Alex]]:''' I hate this.
 
:'''[[Alex Karev|Alex]]:''' I hate this.
 
:'''[[Meredith Grey|Meredith]]:''' I know.
 
:'''[[Meredith Grey|Meredith]]:''' I know.
:'''[[Alex Karev|Alex]]:''' This isn't...this isn't how we were...this isn't how I want to do this. This isn't how Izzie and I were supposed to make a baby.
+
:'''[[Alex Karev|Alex]]:''' This isn't... This isn't how we were... This isn't how I want to do this. This isn't how Izzie and I were supposed to make a baby.
 
----
 
----
 
:'''[[Richard Webber|Richard]]:''' Wait. Um. Wait. No. You can’t take that one.
 
:'''[[Richard Webber|Richard]]:''' Wait. Um. Wait. No. You can’t take that one.
Line 293: Line 393:
 
:'''[[Derek Shepherd|Derek]]:''' It was the first surgery we ever scrubbed in together on right? Our first save. Right here is a cerebral cyst. Tough save, but we did it. I kissed you in the stairwell after the surgery. And this right here is where Dr. Bailey kicked you out of the surgery because she caught us in your driveway in my car. And right here, this was a 7 hour craniotomy and you held the clamp the entire time, never flinched. That’s when I knew you were going to be an incredible surgeon. Beth Monroe, made our clinical trial a success by surviving. You talked me into putting her under. That’s when I knew I needed you. And this is today. The post op head CT of Izzie Stevens. See that, right there? Tumor free. Because of you. You got me into the OR. If there’s a crisis you don’t freeze. You move forward. You get the rest of us to move forward. Because you’ve seen worse. You’ve survived worse. And you know we’ll survive too. You say you’re dark and twisty. It’s not a flaw. It’s a strength. It makes you who you are. I’m not going to get down on one knee. I’m not going to ask a question. I love you Meredith Grey. And I want to spend the rest of my life with you.
 
:'''[[Derek Shepherd|Derek]]:''' It was the first surgery we ever scrubbed in together on right? Our first save. Right here is a cerebral cyst. Tough save, but we did it. I kissed you in the stairwell after the surgery. And this right here is where Dr. Bailey kicked you out of the surgery because she caught us in your driveway in my car. And right here, this was a 7 hour craniotomy and you held the clamp the entire time, never flinched. That’s when I knew you were going to be an incredible surgeon. Beth Monroe, made our clinical trial a success by surviving. You talked me into putting her under. That’s when I knew I needed you. And this is today. The post op head CT of Izzie Stevens. See that, right there? Tumor free. Because of you. You got me into the OR. If there’s a crisis you don’t freeze. You move forward. You get the rest of us to move forward. Because you’ve seen worse. You’ve survived worse. And you know we’ll survive too. You say you’re dark and twisty. It’s not a flaw. It’s a strength. It makes you who you are. I’m not going to get down on one knee. I’m not going to ask a question. I love you Meredith Grey. And I want to spend the rest of my life with you.
 
:'''[[Meredith Grey|Meredith]]:''' And I want to spend the rest of my life with you.
 
:'''[[Meredith Grey|Meredith]]:''' And I want to spend the rest of my life with you.
  +
----
  +
:'''[[Derek Shepherd|Derek]]:''' You know, they're doing tests That show altered brain anatomy in patients with PTSD. They're actually getting close to understanding the physical side of the psychological trauma. It's amazing what you can see with an MRI.
  +
:'''[[Owen Hunt|Owen]]:''' What did Meredith tell you about last night? What did she say?
  +
:'''[[Derek Shepherd|Derek]]:''' Post-traumatic stress is a real injury, Owen. It can be healed. There are resources. Vet centers, therapy... You shouldn't try and handle this on your own.
  +
:'''[[Owen Hunt|Owen]]:''' I came back in one piece. I have both arms, both legs. Lots of guys came back with real injuries. If the worst I have is a couple nightmares or freezing for a moment...
  +
:'''[[Derek Shepherd|Derek]]:''' Is that what happened last night? You had a freezing moment? If you want, I can help.
  +
:'''[[Owen Hunt|Owen]]:''' Oh, yeah? I'm not the one who needs help around here. I'm not the one who cut out half a woman's brain, then ran off to hide. I'm not the one who half this hospital is talking about behind their back. So maybe you should spend a little less time worrying about me, and, you know, just take a look in the mirror, all right?
  +
----
  +
:'''[[Cristina Yang|Cristina]]:''' I don't think... I can't handle it after all.
  +
:'''[[Owen Hunt|Owen]]:''' What? What do you mean?
  +
:'''[[Cristina Yang|Cristina]]:''' I'm sorry. I'm so, so sorry. But I'm lying here in your arms and I'm afraid to fall asleep.
  +
----
  +
:'''[[Richard Webber|Richard]]:''' Shouldn't you and Meredith be out celebrating or something?
  +
:'''[[Derek Shepherd|Derek]]:''' She turned me down, twice. She says she understands. She forgives me for what happened in the woods, but...
  +
:'''[[Richard Webber|Richard]]:''' So you showed her your dark side? Meredith never struck me as a woman who was afraid of the dark.
  +
:'''[[Derek Shepherd|Derek]]:''' I don't know.
  +
:'''[[Richard Webber|Richard]]:''' Do you know it was Meredith's idea to ask Izzie if she wanted to harvest her eggs, so Izzie could have a chance at the future she wanted? The future, Derek. She was confident you'd succeed today. Meredith believes in you.
  +
   
 
==See Also==
 
==See Also==
 
{{Crew}}
 
{{Crew}}
  +
{{Grey Matter}}
 
{{Season 5 (GA)}}
 
{{Season 5 (GA)}}
  +
  +
[[de:Liebesbrief im Aufzug]]
  +
[[fr:Une belle soirée pour sauver des vies]]
 
[[Category:All Episodes]]
 
[[Category:All Episodes]]
 
[[Category:GA Episodes]]
 
[[Category:GA Episodes]]

Revision as of 21:42, 15 April 2019

Surgeons are all messed up. We're butchers, messed up knife happy butchers. We cut people up, we move on. Patients die on our watch, we move on. We cause trauma, we suffer trauma. We don't have time to worry about all the blood and death and crap it really makes us feel. Doesn't matter how tough we are, trauma always leaves a scar. It follows us home. It changes our lives. Trauma messes everybody up, but maybe that's the point. All the pain and the fear and the crap. Maybe going through all of that is what keeps us moving forward. It's what pushes us. Maybe we have to get a little messed up before we can step up.

Elevator Love Letter is the nineteenth episode of the fifth season and the 97th overall episode of Grey's Anatomy.

Short Summary

The pressure is on for Derek as his first surgery back is part of Izzie's treatment, while Alex and George individually try to cope with their feelings for Izzie, as her boyfriend and her best friend, and her diagnosis. Izzie knits, as is alone for the day because nobody comes to visit her. Owen's PTSD hurts Cristina again, this time more violently to the concern of Callie and Meredith. Mark, Karev and Lexie try to keep a patient alive although her family are fed up of her being "almost dead" every month. Derek and Meredith get a happy ending as Cristina loses her own happy ending.

Full Summary

Alex is pacing outside Izzie's room. Izzie herself is fast asleep. A nurse asks him if he would like to have cot set up for him in her room, but he says no. He's a doctor here. He returns to pacing.

Arizona and Callie are dancing at Callie's place.

Cristina has fallen asleep to a surgical video. Owen shuts off the light, covers her with a blanket, and stares at the fan on the ceiling. Owen's eyes close.

The next moment, he's on top of Cristina, choking her. Cristina is gasping for air and tries to break free. Callie is alarmed by the noise and comes in to check. Cristina then manages to break free and flees into the bathroom. Owen comes to his senses.

Meredith's phone rings. It's Callie calling her to tell what happened.

Cristina lets Meredith into the bathroom. Meredith sees her neck and says she'll kill Owen, but Cristina says she's fine and that it was just a nightmare. Owen knocks, wanting to know if she's all right. Cristina opens the door. Owen says he's sorry. He doesn't know what happened. Cristina tells him to look at her and assures him she's okay. She holds him as he cries and keeps repeating it's okay.

Meredith's having breakfast as Derek enters the kitchen. He sits down with her and gives her the ring. She says not like this. Today is about Izzie and his gift to save her. He can do it. Derek decides to go take a shower.

Cristina is wearing a turtleneck under her scrubs to hide her bruised neck. Meredith says this is not okay, and neither is Owen. Alex asks Meredith if Derek is okay to be back. Today is not just any patient, it's Izzie. Meredith says he's fine.

Callie sees Derek, Richard, Alex, Cristina, and Meredith walk by. George comes over and she's surprised he's not going to the big presentation with Izzie. George says he was the very last to know about Izzie. He wants to work and asks Callie if she has room on her service. She does. George takes a chart from her and walks off.

As doctors enter Izzie's room, Bailey tells Meredith, Alex, and Cristina that if they enter Izzie's room, they are her friends, not her doctors. She needs people to hold her hand as she's got enough doctors. They enter the room where Izzie stops knitting. Bailey tells Izzie they have a lot of surgeries and procedures lined up for the coming weeks. One of those surgeries will be removing mets from her liver. Also, Dr. Parker from OB will harvest healthy eggs before she undergoes any radiation so she has the option of having babies for later. Derek says their primary concern for today is the mets on her temporal lobe. Derek is surprised they didn't catch it sooner as it can cause intense hallucinations. Dr. Swender asks if they're done. She tells Izzie that there will be lots of surgeries even for the mets they already know about. Swender will administer chemo, radiation, and immunotherapy. The treatment will be aggressive and harsh, so Izzie should prepare herself. Swender will be overseeing every procedure Izzie has. She welcomes everyone to the cancer wing. The doctors leave. Izzie tells her friends to go save lives now. They leave for rounds, leaving her alone in her room, knitting.

Outside Izzie's room, Derek tells Alex it seems like the tumor hasn't grown since her last scans. Derek asks if he has any concerns. Alex wants him to keep Izzie's frontal lobe in her skull. Derek enters Izzie's room to talk about the surgery. Bailey asks Alex if he's coming, but he says he has to go as he's on an old lady.

Jackie introduces Mark to her brothers Luke and Tobin, who flew in this morning. Their aunt Joyce is very sick. Mark says it's time to say goodbye. Tobin wants to know what time frame they're talking about. She probably won't make it another day. Tobin has a flight to catch in the morning and he can't change it when it's past noon. Luke has to catch a plane tonight. Mark, Lexie, and Alex seem to find them a bit insensitive.

Cristina is walking with Swender, who's doubting about Derek. Swender reviews Izzie's labs and decides to go for IL-2. It's about as bad as it gets. Cristina doesn't want her to tell Izzie now as studies have shown telling patients bad news before surgery drastically increases their chance of complications. Swender says the news remains the same, whenever delivered, and she has time now. Cristina says she believes Izzie is down in radiology, so Swender has to wait an hour.

Richard paged Alex to talk about Izzie's eggs. Frozen eggs have a better survival rate when they're fertilized. It's a lot to digest so Alex can think about it. Alex asks for the cup.

Callie asks Meredith if Cristina is okay. Meredith says she says she is, but she doesn't believe her. Owen comes over, but Meredith blocks him from going over to Cristina.

Owen and Derek are on the helipad, where a helicopter brings in a patient with a massive head trauma following a motorcycle accident. Owen tells Derek it's good to have him back. Owen appears to be hypnotized by the rotor blades. It takes some time before Derek can get through to him. The patient's DOA.

Alex is staring at the cup in an on-call room. He gets paged.

Cristina is complaining about Swender having no vision. Meredith tells her Owen obviously has issues, but that doesn't mean Cristina has to stand by him. Cristina says it's like if he lost a leg or had a heart attack. She can't walk away just because he has war wounds. It's not as bad as Meredith thinks it is.

Alex and Lexie are shocking Joyce, successfully reviving her. Jackie and her brothers are disappointed. Alex calls them vultures. Tobin explains Joyce had one month to live, three years ago. They were crushed and they stayed with her for weeks and said their goodbyes, and then she stabilized. Ever since, Joyce has been in and out of the hospital every month. They always jump on planes and say their goodbyes again. Each time, Joyce winds up getting better. Everyone is ready for her to move on.

Derek and Owen are sitting in the ambulance bay. Derek tells him researchers are close to understanding the physical side of the psychological trauma that is PTSD. Owen asks what Meredith told him about last night. Derek says PTSD can be healed. Owen says he came back in one piece. Lots of guys came back with real injuries. Derek says he can help, but Owen says he's not the one who needs help here. He's not the one who took out half a woman's brain. He suggests Derek look in the mirror. Owen goes back inside.

Richard is outside the on-call room to check how Alex is doing. Alex would be better if he weren't out there listening. Richard apologizes. Meredith comes in and says she came in case Alex needed to talk. Alex says talking won't help. A cup with his swimmers won't make everything okay. Alex wonders if they'll even get a chance to use the frozen embryos. He wonders if Izzie will survive. Izzie told him she was seeing a ghost, but he's so used to crazy women in his life that he didn't think about it. This isn't how it's supposed to happen, how he wanted to do this. 

Cristina enters the vent room, but Owen's already in there. She says she hasn't seen him all day. He wonders what if he hadn't woken up. He has no memory of what happened. He would never hurt her, but he did. He doesn't understand how his hands could have been capable. Cristina tells him not to blame himself for something that's out of his control. Owen says they have to stop seeing each other. Cristina knows her limits. She'll decide what she can handle. She sees the scratches on his neck and leaves the room.

Izzie uses Bailey to measure the scarf she's knitting. Bailey thinks it's for Alex and says she hasn't seem him much today. Izzie says he's working like everybody else. She told them to do that. Bailey says she has a colectomy this afternoon. She asks what Izzie would do to divide the cecum. Bailey has decided not to let Izzie fall behind as she'll need to know how to do this a year from now. She really believes Izzie will be around then.

Derek's in the OR by himself, talking himself through the procedure. He's breathing heavily and staring at his hands, then decides to start over.

Richard's eating lunch in a conference room as Alex delivers the filled cup. Richard tells him to go talk to Izzie as they're basically conceiving a child today. Alex says he has done his part and leaves. Richard moves the cup away from his food.

The residents sit down in the cafeteria. Nobody knows how Izzie is doing, not even Alex.

Izzie's in her room by herself as Bailey comes in. She notices Izzie has finished the scarf. She asks if no one came up to visit. Izzie understands and she says Bailey doesn't need to keep checking on her. Bailey says she has to be there to start Izzie on her meds before the surgery. She talks about her colectomy. She found a mass inside the patient and talks about how they resected it.

In the chapel, Callie tells Arizona she wished Izzie dead for weeks. And now, it's happening. She wonders what kind of person would wish for this to happen. Arizona asks if she's praying for Izzie to die right now. Callie says no. She's praying for Izzie to live.

Joyce is coding again. Alex asks her nephews and niece to wait outside. He shocks Joyce and asks her not to give her family the satisfaction. He shocks her again, which revives her. Joyce opens her eyes and Alex introduces himself. He tells her she worked hard today. Joyce says her family is impatient. It's been a long time, but they always come. They are her people. People keep you going. People are better than no people.

Derek is scrubbing in with Richard by his side. Meredith comes in to give Derek his ferry boat scrub cap.

Derek follows Meredith out to the hallway. He needs her to say yes now, so it's regardless of the outcome of the surgery. She says she can't, not if agreeing to marry him will make it okay for Izzie to die. She loves him and he can do this. She knows he can.

Alex rushes into Izzie's room, but she's gone.

Izzie's on the table in Derek's OR. Izzie looks at him as he enters. He tells her he'll see her soon. She hopes so. Bailey knows so. Izzie tells Bailey the scarf is for her, in case anything goes wrong. Derek says it's a beautiful night to save lives. Bailey then puts Izzie under.

George is smashing a cast with a hammer. Callie doesn't get why he's not with Izzie, but he doesn't want to talk about it. He asked Izzie hundreds of time what was wrong and she ignored him, and when she actually needed help, she turned to Cristina, of all people. Callie says there's also the fact that his best friend might die on him. Callie takes the hammer from his hands. She says they're going to wait for Izzie, and he owes her this, because she wished Izzie dead because he slept with her. Callie knows him and she knows that he cares if Izzie lives or dies.

Meredith informs Alex and Cristina that the surgery has started. Intern Steve comes over and asks if the surgery has started. Meredith wants the interns to go, but Alex says they can stay as people are better than no people.

In the OR, Derek is ready to buzz the superficial temporal artery. He's going for tenting sutures. Bailey says he can take his time. Everyone here is on his side. Swender asks if they're gonna hold with all the friable scar tissue. Bailey trusts him as she saw him do it with even more friable tissue.

Lexie is shocking Joyce, but it's unsuccessful this time. Joyce is gone. Jackie thanks her. Suddenly, Joyce heart starts beating again. The family rolls their eyes and says it's never going to end. Lexie listens with her stethoscope and says it's just Joyce's pacemaker. She's really gone. However, Lexie has to get her superior as she's not authorized to call time of death in this situation.

Callie and George joins the others who are waiting for Izzie. Meredith once again says the choking is unacceptable, but Cristina bounces back that she's had a ring thrown in her face.

Mark shuts the pacemaker down and calls time of death. Lexie tells Jackie, Tobin, and Luke they can now leave and catch their plane. They actually want to stay a little while longer. They all start crying.

Richard asks the waiting doctors what they're doing. Alex says they're waiting for Izzie. Richard says he's scared, too.

Derek finds some of the Sylvian vessels are wrapped around the tumor capsule. He asks for a Penfield four, which surprised Swender. Derek is sure of his choice and finds his confidence.

Bailey goes to tell the doctors that Derek managed to resect all of the tumor. Izzie's going to be in the PACU for an hour, but she'll be fine. Everyone is relieved. Bailey tells Izzie's friends that that is not thanks to them. She tells them to do better tomorrow.

Richard wonders why Derek and Meredith aren't celebrating. Derek says Meredith turned him down twice. Richard says Derek showed her his dark side, but Meredith never struck him as someone who's afraid of the dark. Derek doesn't know. Richard says it was Meredith's idea to ask Izzie about harvesting her eggs. That shows that she was confident that Derek would succeed. Meredith believes in him. Derek then starts shaving off his beard.

Alex enters Izzie's room. He's crying and tells her he's right here. He takes her hand. Bailey, wearing her scarf, passes by outside the room.

Cristina tells Owen that Izzie's surgery went well. He wishes things were different. So does she. He asks if he can hold her. She lets him and they kiss. They take off their shirts and lie down on a bed, and proceed to have sex.

Meredith is about to get on an elevator, but Richard rushes over and tells her she can't take that one. He blocks her until the doors close. She pushes the button again. The other elevator arrives. Its walls are full of scans and files. Derek welcomes her as she gets in. He shows her Katie Bryce's CT. That was their first surgery together. Another scan shows a patient whose cerebral cyst they removed. It was tough, but they did it. After that surgery, he kissed her in the stairwell. Another scan is from the time Bailey kicked Meredith out of the OR because she caught them in his car. Another scan is from the time she held a clamp for 7 hours and never flinched. That's when he knew she was going to be a great surgeon. Also there are Beth Monroe's scans, the first patient to survive their trial. Meredith talked him into operating on her. That's when he knew he needed her. He finally shows her Izzie's post-op head CT from today. Her brain is tumor-free. Derek says that's because of Meredith, as she got him into the OR. If there's a crisis, Meredith moves forward instead of freezing, and she gets everyone else to move forward, because she's seen and survived worse. She knows they'll survive, too. Being dark and twisty is a strength, not a flaw. It makes her who she is. He won't get down on one knee to ask her a question. He loves her and he wants to spend the rest of his life with her. She says she wants to spend the rest of hers with him. They kiss.

Owen and Cristina are lying in bed. She doesn't think she can handle this after all. She's sorry, but lying her in his arm, she's afraid to fall asleep.

Owen's in the MRI. He apologizes to Derek for what he said earlier. Derek says it's all forgotten. Owen thanks him for doing this. Derek activates the scanner.

At home, Cristina is staring at the fan. Meredith enters her bedroom and tells Cristina she's engaged. Cristina says she broke up with Owen. Meredith lies down next to her.

Alex lies down in bed with Izzie. She wakes up and he tells her he snooched into a cup for her today. She guesses she should thank him. Meanwhile, Alex's voice over says that maybe going through all the pain that comes with trauma is what keeps you moving forward. Maybe we have to get a little messed up before we can step up.

Cast

Main Cast

Guest Stars

Co-Starring

Uncredited

  • Frances Bay as Joyce Wallington

Medical Notes

Izzie Stevens

  • Diagnosis:
    • Stage IV metastatic melanoma
    • Liver mets
    • Skin mets
    • Brain met
  • Treatment:
    • Liver met resections
    • Brain met resection
    • DTIC
    • High-dose IL-2

Izzie had been admitted to the hospital to start her cancer treatment. They planned to resect her liver mets and harvest eggs from her ovaries. Derek also wanted to address her brain mets. He eventually took her into surgery to remove them. The surgery went well and was successful.

Callie's Patients

  • Diagnosis:
  • Treatment:
    • Hip replacement
    • Tibia/fibula repair

Callie told George she had three hip replacements scheduled that day, plus a tib/fib repair.

Joyce Wallington

  • Diagnosis:
  • Treatment:

Joyce's family was told she had less than 24 hours to live. She'd had surgery and was not doing well. She coded several times and was brought back before finally dying.

ER Patient

  • Diagnosis:
  • Treatment:

Owen and Derek waited on the roof together for a patient with head trauma. The patient was DOA.

Bailey's Patient

  • Diagnosis:
    • Tumor
  • Treatment:
    • Colectomy
    • Tumor resection

Bailey told Izzie she was doing a colectomy that afternoon and asked her questions about it. She later came back to tell Izzie that the surgery went well. She said that she found a tumor during the surgery which she resected.

Owen Hunt

  • Diagnosis:
    • PTSD
  • Treatment:

Owen had Derek do an MRI after Cristina told him she was afraid to fall asleep with him there because Derek had mentioned that you could see the changes in brains with PTSD.

Music

Song Performer Scene
"Little Pieces" Gomez
  • Alex paces outside Izzie's room.
  • Callie and Arizona dance it out together.
  • Owen and Cristina go to sleep after watching a surgical video. Owen stares at the ceiling fan.
"The Weight of Us" Sanders Bohlke
  • Alex tells Meredith this is not how he and Izzie were supposed to make a baby.
  • Cristina and Owen talk in the vent room. She assures him she knows her own limits.
  • Bailey checks up on Izzie, who's knitting a scarf.
"That Home" The Cinematic Orchestra
  • Alex goes to Izzie's room and she is not there.
  • Izzie is in the O.R. with Derek and Miranda. She tells the scarf is for Miranda. Derek says it is a beautiful night to save lives.
"Rise Up" Ben Lee
  • Aunt Joyce finally dies and her family decides to stay a little while longer to say goodbye for real.
  • The residents and interns are waiting for Izzie, and Richard admits he's scared, too.
  • In the OR, Derek finds his confidence back.
  • Bailey tells the waiting doctors that Izzie is fine. She tells Izzie's friends to do better tomorrow.
"With the Notes in My Ears" Peter Broderick
  • Derek shaves off his beard.
  • Alex tells Izzie he's here for her. Bailey, wearing her scarf, watches from outside the room.
  • Cristina and Owen have sex in an on-call room.
"We Do What We Want To" O+S
  • Derek shows Meredith the scans in the elevator and proposes to her in the elevator.
  • She accepts his proposal.
  • Cristina admits she can't handle this thing with Owen after all as she's scared to lie in his arms.
  • Owen finally accepts Derek's help and gets in the scanner.
  • Meredith tells Cristina she's engaged, and Cristina tells her she broke up with Owen.
  • Alex lies down with Izzie and tells her about the cup. 

Notes and Trivia

Grey's_Anatomy_5x19_Promo

Grey's Anatomy 5x19 Promo

  • This episode's title originated from the song Elevator Love Letter, originally sung by the Canadian band, Stars.
  • This episode scored 16.10 million viewers.
  • When Meredith is leaning on the OR Board while Izzie's in surgery you can see Izzie's birthday as 06/23/81. So, that would make Izzie almost 28 years old
  • While the Chief is eating, Alex hands him a cup of his sperm. After Alex leaves, a disgusted Chief moves the cup away from him with his fork. This is illogical as he uses the same fork to eat.
  • There's a deleted scene of this episode in which Alex, Meredith, George, Cristina, Callie and Lexie are waiting in Izzie's room for her to wake up. While they are waiting, Bailey walks by, wearing the scarf that Izzie made her.

Gallery

Episode Stills

Quotes

Richard: (knocking) Karev? Just checking in. Seeing how you're coming– ah, just seeing how you're doing.
Alex: I'd be doing a lot better if you weren't on the other side of the door listening.
Richard: Right, right. Sorry.
Meredith: (knocking)
Alex: I said go away.
Meredith: (entering anyways) You left the door unlocked. That's bold.

Alex: You think talking will help? You think a dixie cup of my swimmers will make everything okay? It's crap. This is crap! You just cant go messing with peoples heads like that! Even if she freezes the embryos you think, you think we'll get a chance to use them?! You think she'll still be here? You think she'll survive all this?! You think... I think.. She told me, she told me she was seeing a ghost, okay? And I'm so used to all the crazy chicks in my life that I didn't even... I'm a doctor. A doctor! And I didn't even think to... And now she's... This is wrong. This isn't how it's supposed to happen.
Meredith: I know.
Alex: It's crap.
Meredith: I know.
Alex: I hate this.
Meredith: I know.
Alex: This isn't... This isn't how we were... This isn't how I want to do this. This isn't how Izzie and I were supposed to make a baby.

Richard: Wait. Um. Wait. No. You can’t take that one.
Meredith: Why not?
Richard: I said don't take it.
Meredith: I will take the elevator I want to take.
(The Chief blocks the elevator doors. They close and Meredith presses the button for a new elevator. The other elevator doors open.)
Richard: Well go on.
Derek: Hey! Come on in. This is a CT of Katie Bryce. 15 year old female severed aneurysm.
Meredith: From a fall during rhythmic gymnastics, I remember.
Derek: It was the first surgery we ever scrubbed in together on right? Our first save. Right here is a cerebral cyst. Tough save, but we did it. I kissed you in the stairwell after the surgery. And this right here is where Dr. Bailey kicked you out of the surgery because she caught us in your driveway in my car. And right here, this was a 7 hour craniotomy and you held the clamp the entire time, never flinched. That’s when I knew you were going to be an incredible surgeon. Beth Monroe, made our clinical trial a success by surviving. You talked me into putting her under. That’s when I knew I needed you. And this is today. The post op head CT of Izzie Stevens. See that, right there? Tumor free. Because of you. You got me into the OR. If there’s a crisis you don’t freeze. You move forward. You get the rest of us to move forward. Because you’ve seen worse. You’ve survived worse. And you know we’ll survive too. You say you’re dark and twisty. It’s not a flaw. It’s a strength. It makes you who you are. I’m not going to get down on one knee. I’m not going to ask a question. I love you Meredith Grey. And I want to spend the rest of my life with you.
Meredith: And I want to spend the rest of my life with you.

Derek: You know, they're doing tests That show altered brain anatomy in patients with PTSD. They're actually getting close to understanding the physical side of the psychological trauma. It's amazing what you can see with an MRI.
Owen: What did Meredith tell you about last night? What did she say?
Derek: Post-traumatic stress is a real injury, Owen. It can be healed. There are resources. Vet centers, therapy... You shouldn't try and handle this on your own.
Owen: I came back in one piece. I have both arms, both legs. Lots of guys came back with real injuries. If the worst I have is a couple nightmares or freezing for a moment...
Derek: Is that what happened last night? You had a freezing moment? If you want, I can help.
Owen: Oh, yeah? I'm not the one who needs help around here. I'm not the one who cut out half a woman's brain, then ran off to hide. I'm not the one who half this hospital is talking about behind their back. So maybe you should spend a little less time worrying about me, and, you know, just take a look in the mirror, all right?

Cristina: I don't think... I can't handle it after all.
Owen: What? What do you mean?
Cristina: I'm sorry. I'm so, so sorry. But I'm lying here in your arms and I'm afraid to fall asleep.

Richard: Shouldn't you and Meredith be out celebrating or something?
Derek: She turned me down, twice. She says she understands. She forgives me for what happened in the woods, but...
Richard: So you showed her your dark side? Meredith never struck me as a woman who was afraid of the dark.
Derek: I don't know.
Richard: Do you know it was Meredith's idea to ask Izzie if she wanted to harvest her eggs, so Izzie could have a chance at the future she wanted? The future, Derek. She was confident you'd succeed today. Meredith believes in you.


See Also

A complete overview of this episode's crew can be found here.

The Grey Matter blog post on this episode can be found here.